Developing a personal nursing philosophy through caring, communication, and attitude

Nursing

Since Florence Nightingale's selfless service to those suffering in hospitals, nursing has been recognized as not only a profession, but also a calling. This is what nursing is for me. I have always felt that, more than other professions, nursing provides the professional with the opportunity to connect with other human beings on multiple levels. On the clinical level, nursing provides the opportunity for learning about the miracle that is the human body. On the non-physical level, the nurse has the opportunity to understand the client not only on the level of medical need, but also on the psychological and even spiritual level. These levels all work together in promoting the healing process. For this reason, I also believe that it is vitally important to develop an individually applicable nursing philosophy. Being highly personal to each nurse, this philosophy can help the nurse to provide optimal service to the client, as the professional will project the internal drivers for such a philosophy. In developing my own nursing theory, I have been particularly influenced by the work of theorists such as Jean Watson and Bonnie W. Duldt. By examining the philosophies behind the work of these three theorists, I was able to isolate the most important elements of nursing as attitude, communication and caring.

Definition

In defining nursing, as mentioned above, the most important elements of the profession include attitude, communication and caring. It is vitally important for the nurse to display a caring attitude, as the professional is faced with a problem on multiple levels. The primary level is the physical: the client's most predominant and most obvious need is physical, which is why the patient is in the hospital. This is however only the surface of the problem. The way in which the client experiences the problem on a psychological, emotional and spiritual level is vitally important to the healing process. In this way, the attitude of the nurse needs to be open, honest and accepting, as well as profoundly patient. The nurse should be willing to listen to any complaints that the patient has about his or her condition, and the care for this condition.

Communication is deeply integrated with an attitude of acceptance and patience. The nurse needs to be able listen on a deeper level than just the conversation of the client. Such conversation provides vital clues to the inner experiences of the client, and should be evaluated to determine the best treatment for the fastest healing process. Communication is a process specifically addressed by Bonnie Duldt (1985), who holds that communication is the basis of helping the patient "feel human." For Duldt, the feeling of humanity lies at the basis of the healing process. It is the purpose of the nurse to promote this feeling in clients in order to help them with the healing process.

In terms of caring the paradigms of attitude and communication integrate to result in an overall effect of caring. Caring translates to the non-physical aspects of nursing that help the healing process. Jean Watson (2006) has devised a theory of caring that is based upon the interaction of human beings with each other. For Watson, everything is interrelated, including not only human beings, but also the environment and the earth in an ultimately holistic sense. In this, the paradigm of caring is based upon the interaction between the nurse, the client, family members and friends of the client, as well as the environment and how these interact for the optimal well-being and healing of the client. This integration of the environment and its effect upon human health is a theory addressed by Duldt.

In defining my own concept of nursing then, I would summarize by asserting that nursing for me is a calling that expects me to be able not only to determine and care for the physical problems of the client, but also for the non-physical such as the emotional and psychological experience of the condition. I will do this by considering the client in a holistic sense, while also taking into account environmental and social factors. Nursing is an integrated profession of caring and ultimate healing through acceptance, caring, and communication.

Assumptions

My assumptions relate to the integration of various factors in each client's life. These factors may include, to a greater or lesser extent, the physical environment, the social environment, the inner psyche of the client, as well as the physical body. Everything that human beings experience in the world is experienced via the physical body. When the physical body becomes unwell, it is logical to assume that, while the experiences in the world of the client did not necessarily cause the illness, these interactions might indeed hinder the healing process.

Negative attitudes from a client's friends for example may be communicated to the body as an obstacle to healing. I also believe that a client's attitude in itself may either aid or hinder the healing process. A negative attitude could be exacerbated by environmental factors.

Like Watson and Duldt, I also believe that the client should be seen in a holistic manner and treated with consideration of possibly negative or potentially environmental, social, or interpersonal factors. In investigating the optimal healing process, the nurse should then be a catalyst for increasing the positive factors and diminishing the negative.

Principles

The most important principle of nursing is to do no harm. This is the most basic principle of all healthcare professions. However, situations could arise where harm is unavoidable, or where in attempting to respect a client's rights, autonomy, or privileges may cause severe harm to others. In such a case, I believe it is best to consider the interaction of all human beings and the environment. In situations of this nature, I would act upon my assumption of integration and take actions that would cause the least harm not only to the client, but also to those whose lives are affected by my decision and by the client's rights.

Another case may be where the rights of a client brings harm to the client him- or herself. When a client with cancer for example refuses life-saving treatment, I would do my best to persuade the client otherwise. I would do so on the principle of attempting to cooperate with the client rather than directly opposing him or her, but if no other choice is left to me, I would have to act in what I believe is the client's best interest. I would also attempt to find reasons for the client's apparently suicidal decision-making process, and attempt to address this before overriding the client directly.

Conclusion

My philosophy of nursing generally focuses on the integration of the all things in the client's life to create the individuals that I am presented with. Problems within the physical body are more often than not at least affected, if not directly caused, by factors beyond the physical. I see it as the duty of the nurse to investigate the causes for physical illness not only on the physical level, but also on the non-physical. From the physical investigation, I would therefore move progressively towards other factors, including those within the psyche of the client, those relating to the client's interpersonal and social environment, as well as those within the general environment where the client lives and moves on a daily basis.

In the past, nursing was often seen as a primarily physical science. Only recently has it become evident that not only the body, but other factors also play a role in illness and healing. This is however a relatively new paradigm in the profession, and future challenges may revolve around how to quantify the non-physical causes of illness. More than a challenge, however, this is also an exciting new field of investigation that nurses can use to provide their clients with optimal healthcare.

Sources

American Nurses Assocaition. (2003). ANA Code of Ethics for Nurses - Continuing Education. http://nursingworld.org/mods/mod580/cecde03.htm

Duldt, Bonnie W. (1985). Humanistic Nursing Communication Theory.

A www.bwbatteyconsult.com/T-HNCT.doc

Watson, Jean (2006). Theory of Human Caring. http://www2.uchsc.edu/son/caring/content